245 - Toxic epidermal necrolysis and Stevens–Johnson syndrome

Abstract

Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) belong to the same spectrum (‘epidermal necrolysis’) of rare, potentially life-threatening conditions usually caused by drugs. The causative drug should be quickly identified and discontinued. At the acute phase, the cornerstone of the management of SJS/TEN is supportive care in a center of reference (dermatology, burn or intensive care unit): warm environment, fluid replacement, nutritional support, analgesia, organ support, surveillance for infection, mucous membrane (especially ocular) management, and appropriate dressings. Respiratory failure can occur, requiring mechanical ventilation. The efficacy of immunomodulatory agents (including systemic steroids, ciclosporin, intravenous immunoglobulins, anti-tumor necrosis factor such as etanercept) at the acute phase of the disease remains of debate.